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重度精神疾病成年患者老龄家庭的服务利用模式及预测因素与未满足的需求

Patterns and predictors of service use and unmet needs among aging families of adults with severe mental illness.

作者信息

Smith Gregory C

机构信息

Human Development Center, School of Family and Consumer Studies, 111 Nixson Hall, Kent State University, Kent, Ohio 44242, USA.

出版信息

Psychiatr Serv. 2003 Jun;54(6):871-7. doi: 10.1176/appi.ps.54.6.871.

Abstract

OBJECTIVE

This study examined patterns and predictors of use of and unmet need for support services among aging families of adults with severe mental illness by using an expanded version of the Andersen Behavioral Model.

METHOD

S: Mailed surveys were completed by 157 mothers from 41 states who lived with and provided care to adult offspring with serious mental disorders, primarily schizophrenia or schizoaffective disorders. The mean age of the mothers was 67 years (range, 50 to 88 years).

RESULTS

Although unique patterns were observed among individual services, overall service use was low despite high perceived need for services. The greatest unmet needs were for social or recreational programming, training in behavior management, and information on planning for the future. Regression analyses based on the expanded Andersen model revealed that greater service use occurred when offspring spent their days away from home, mothers received higher levels of informal support, and offspring were in poorer physical health. Greater unmet needs for services were reported when mothers experienced higher burden, perceived more age-related changes in themselves, and had offspring who typically spent their days at home.

CONCLUSION

S: The needs and resources of the entire family, including access to informal social support, should be considered in attempts to identify predictors of the use of and need for services among persons with chronic and severe mental illness. The findings of this study also point to the need for family education in how to locate community services as well as for better and more sensitive community services intended for the entire aging family.

摘要

目的

本研究采用扩展版的安德森行为模型,调查了患有严重精神疾病成年人的老龄家庭中支持服务的使用模式及预测因素,以及未满足的支持需求。

方法

向来自41个州的157位母亲邮寄了调查问卷,这些母亲与患有严重精神障碍(主要是精神分裂症或分裂情感性障碍)的成年子女生活在一起并为其提供照料。母亲的平均年龄为67岁(范围为50至88岁)。

结果

尽管各项服务呈现出独特的使用模式,但尽管对服务的感知需求很高,总体服务使用率却很低。未满足的最大需求是社会或娱乐活动安排、行为管理培训以及未来规划信息。基于扩展版安德森模型的回归分析显示,当子女白天不在家、母亲获得更高水平的非正式支持以及子女身体健康状况较差时,服务使用率更高。当母亲负担较重、感知到自身更多与年龄相关的变化且子女通常白天在家时,报告的服务未满足需求更大。

结论

在试图确定慢性严重精神疾病患者服务使用和需求的预测因素时,应考虑整个家庭的需求和资源,包括获得非正式社会支持的情况。本研究结果还表明,需要开展关于如何找到社区服务的家庭教育,以及需要为整个老龄家庭提供更好、更贴心的社区服务。

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